Psychosocial characteristics of patients evaluated for kidney transplant and associations with functional and frailty metrics at a veterans affairs hospital

Priyadarshini Manay; Patrick Ten Eyck; Erin Siniff; Grace Binns; M. Lee Sanders; Melissa Swee; Jodell L. Hornickel; Roberto Kalil; Daniel A. Katz

doi:10.1111/ctr.14530

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Psychosocial characteristics of patients evaluated for kidney transplant and associations with functional and frailty metrics at a veterans affairs hospital

Journal article

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Peer reviewed

Psychosocial characteristics of patients evaluated for kidney transplant and associations with functional and frailty metrics at a veterans affairs hospital

Priyadarshini Manay, Patrick Ten Eyck, Erin Siniff, Grace Binns, M. Lee Sanders, Melissa Swee, Jodell L. Hornickel, Roberto Kalil and Daniel A. Katz

Clinical transplantation, Vol.36(2), pp.e14530-n/a

02/2022

DOI: 10.1111/ctr.14530

PMCID: PMC10305838

PMID: 34783397

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10305838/pdf/nihms-1903289.pdfView

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Abstract

Background The effect of psychosocial problems on listing outcomes and potential interactions with functional metrics is not well‐characterized among Veteran transplant candidates. Methods The results from psychosocial evaluations, frailty metrics, and biochemical markers were collected on 375 consecutive Veteran kidney transplant candidates. Psychosocial diagnoses were compared between patients listed or denied for transplant. Functional abilities were compared among patients with or without psychosocial diagnoses and then evaluated based on reason for denial. Results Eighty‐four percent of patients had a psychosocial diagnosis. Common issues included substance or alcohol abuse (62%), psychiatric diagnoses (50%), and poor adherence (25%). Patients with psychiatric diagnoses, cognitive impairments, and poor adherence were more likely to be denied for transplant (P < .05). Patients with depression, PTSD, and anxiety did not have worse functional ability, but experienced more exhaustion than patients without these problems. Patients denied for medical but not purely psychosocial reasons had worse troponin and functional metrics compared with listed patients. Conclusion Over 80% of patients with a psychosocial diagnosis were listed; however, poor adherence was a particularly important reason for denial for purely psychosocial reasons. Patients with psychosocial diagnoses generally were not more functionally limited than their counterparts without psychosocial diagnoses or those listed for transplant.

depression

frailty

kidney transplant evaluation

listing outcomes

models

nonadherence

pedometer

psychosocial

treadmill

up‐and‐go

Details

Title: Subtitle: Psychosocial characteristics of patients evaluated for kidney transplant and associations with functional and frailty metrics at a veterans affairs hospital
Creators: Priyadarshini Manay - University of Iowa
Patrick Ten Eyck - University of Iowa
Erin Siniff - Veterans Health Administration
Grace Binns - Veterans Health Administration
M. Lee Sanders - University of Iowa Hospitals and Clinics
Melissa Swee - University of Iowa Hospitals and Clinics
Jodell L. Hornickel - Veterans Health Administration
Roberto Kalil - University of Maryland Medical Center
Daniel A. Katz - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Clinical transplantation, Vol.36(2), pp.e14530-n/a
DOI: 10.1111/ctr.14530
PMID: 34783397
PMCID: PMC10305838
NLM abbreviation: Clin Transplant
ISSN: 0902-0063
eISSN: 1399-0012
Number of pages: 14
Grant note: The University of Iowa Clinical and Translational Science Award ‐ NIH (UL1TR002537)
Language: English
Date published: 02/2022
Academic Unit: Biostatistics; Surgery; Nephrology; Internal Medicine
Record Identifier: 9984322792902771

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